Chronic Kidney Disease – Mineral Bone Disorder

2008 ◽  
Vol 28 (2_suppl) ◽  
pp. 5-10
Author(s):  
Sharon M. Moe
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Osteodystrophy ◽  
Consensus Conference ◽  
Mineral And Bone Disorder ◽  
Mineral Bone Disorder ◽  
Bone Disorder ◽  
The Many ◽  
Bone Abnormalities

The definition, evaluation, and classification of the mineral abnormalities and bone disease in chronic kidney disease (CKD) should encompass all three clinical components: • Abnormalities in serum biochemistries • Vascular calcification • Bone abnormalities This principle was discussed at a Kidney Disease: Improving Global Outcomes consensus conference, resulting in a recognition of the shortcomings of the current classification and a recommendation for the development of new terminology. The recommendation was that the term “renal osteodystrophy” be used exclusively to define the bone pathology associated with CKD. The many clinical, biochemical, and imaging abnormalities that have heretofore been identified as correlates of renal osteodystrophy should be defined more broadly as a clinical entity or syndrome called “chronic kidney disease – mineral and bone disorder.” The hope is that this new terminology will enhance communication and facilitate research worldwide.

Chronic kidney disease-mineral and bone disorder

2018 ◽  
Author(s):  
Stuart M. Sprague ◽  
Menaka Sarav
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Osteodystrophy ◽  
Mineral Metabolism ◽  
Bone Biopsy ◽  
Fibroblast Growth Factor 23 ◽  
Critical Role ◽  
Specific Treatment ◽  
Mineral And Bone Disorder ◽  
Bone Disorder

The kidneys play a critical role in maintaining normal serum calcium and phosphorus concentrations, under the regulation of three main hormones: parathyroid hormone, calcitriol, and fibroblast growth factor 23. With the progression of chronic kidney disease (CKD), most patients develop CKD–mineral and bone disorder (CKD-MBD), which is a systemic disorder involving derangement in mineral metabolism, renal osteodystrophy, and extraskeletal calcification. Disturbances in mineral metabolism develop early in CKD and include phosphate retention, hypocalcaemia, vitamin D deficiency, and hyperparathyroidism. Renal osteodystrophy involves pathologic changes of bone morphology related to progressive CKD and is quantifiable by histomorphometry, based on bone biopsy. CKD-MBD is associated with significant morbidity, including bone loss, fractures, cardiovascular disease, immune suppression, as well as increased mortality. As the disorder begins early in the course of CKD, a proactive approach with intervention is important. Therapeutic strategies could then be employed to prevent and correct these disturbances, aiming to improve cardiovascular outcomes and survival. Current practice guidelines for CKD-MBD are based on insufficient data and high-quality studies are required before specific treatment can be advocated strongly.

scholarly journals Clinical Epidemiology of Mineral Bone Disorder Markers in Prevalent Hemodialysis Patients in the Xinjiang Uyghur Autonomous Region in China

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Ying-Ping Sun ◽  
Wen-Jun Yang ◽  
Su-Hua Li ◽  
Yuan-yuan Han ◽  
Jian Liu
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Practice Patterns ◽  
Clinical Epidemiology ◽  
Care Program ◽  
Mineral And Bone Disorder ◽  
Mineral Bone Disorder ◽  
Bone Disorder ◽  
Xinjiang Uyghur Autonomous Region ◽  
Dialysis Outcomes

We investigated the clinical epidemiology of mineral bone disorder markers in prevalent hemodialysis (HD) patients in Xinjiang, the largest province in China. Data were obtained from 59 hospitals. A total of 3725 patients tracked from January 1 to December 31, 2014, were enrolled. Serum calcium (Ca) levels, phosphorus (P) levels, and intact parathyroid hormone (iPTH) levels were analyzed. Serum Ca levels were lower compared to the International Dialysis Outcomes and Practice Patterns Study (DOPPS4) and the Chinese DOPPS. The hypercalcemia rate was similar to DOPPS4 and lower than in the Chinese DOPPS. Serum P levels were higher than in DOPPS4 and lower than those in the Chinese DOPPS. Hyperphosphatemia rates were higher than DOPPS4 and lower than Chinese DOPPS. Serum iPTH levels were higher than in DOPPS4 and the Chinese DOPPS. We demonstrated higher serum P and iPTH levels in Xinjiang HD patients than in the DOPPS4 and Chinese DOPPS. In contrast, serum Ca levels were lower than the other two studies. High hypocalcemia and hyperphosphatemia rates may suggest that HD services in Xinjiang are inadequate. A multidiscipline chronic kidney disease (CKD) care program needs to be established to improve chronic kidney disease-mineral and bone disorder (CKD-MBD) target achievement in Xinjiang.

scholarly journals Chronic Kidney Disease-Mineral Bone Disorder in Diabetes Mellitus Patients

2012 ◽  
Vol 19 (1) ◽  
pp. 89-98
Author(s):  
Iulia-Daniela Vladu ◽  
Daniela Cana ◽  
Cristina Vaduva ◽  
Corina Grauntanu ◽  
Sorin Zaharie ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Metabolism ◽  
Adverse Outcomes ◽  
Mineral And Bone Disorder ◽  
Vitamin D Metabolism ◽  
Mineral Bone Disorder ◽  
Cardiovascular Morbidity And Mortality ◽  
Bone Disorder

Chronic Kidney Disease-Mineral Bone Disorder in Diabetes Mellitus PatientsDiabetes mellitus (DM) and chronic kidney disease (CKD) are two diseases with increasing prevalence and adverse outcomes that represent an international health problem. Chronic kidney disease- mineral and bone disorder (CKD-MBD) is defined as a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of the following: abnormalities of calcium, phosphorus, PTH, or vitamin D metabolism; abnormalities in bone turnover, mineralization, volume, linear growth, or strength and vascular or other soft-tissue calcification. Disturbances in mineral and bone metabolism are prevalent in CKD and are an important cause of decreased quality of life, cardiovascular morbidity and mortality; these disturbances settle in earlier and have a more severe evolution in DM patients.

Potential effect of pharmaceutical care to improve outcomes in patients with chronic kidney disease-mineral bone disorder in Sulaimani dialysis centers

2020 ◽  
pp. 82-94
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pharmaceutical Care ◽  
Biochemical Parameters ◽  
Positive Impact ◽  
Potential Effect ◽  
Care Group ◽  
Mineral Bone Disorder ◽  
Bone Disorder

Objective: the present study was aimed to evaluate the role of pharmaceutical services in improving the outcome of mineral bone disorder in patients with advanced chronic kidney disease. Methodology: One hundred and twenty patients with chronic kidney disease-mineral bone disorder (CKD-MBD) screened for eligibility, seventy-six patients enrolled in the study and randomly allocated into two groups: pharmaceutical care and usual care, both groups interviewed by the pharmacist using specific questionnaire for assessing the quality of life (QoL). All the drug related problems (DRPs) including drug-drug interactions (DDIs) were recorded by the pharmacist. Blood samples were collected and utilized for analyzing the levels of vitamin D, phosphorous, calcium, albumin and parathyroid hormone at baseline and three months after. The pharmaceutical care group received all the educations about their medications and how to minimize DRPs; improve the QoL. Additionally, the pharmaceutical intervention included correcting the biochemical parameters. Results: Pharmaceutical care significantly improved patients QoL and minimized DRPs and DDIs. It was also effective in improving the biochemical parameters. Conclusion: Pharmaceutical care has a positive impact on improving the outcome of patients with CKD-MBD through attenuating DRPs, improving the biochemical parameters and the QoL.

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